床边和手术室气管切除术:一个成本效益和经济评估
William Yu Luo1, Jaclyn Portelli Tremont2, Sachi Vivek Shinde2
1University of North Carolina at Chapel Hill School of Medicine, Department of Surgery, Chapel Hill, NC, USA; WakeMed Health and Hospitals, Raleigh, NC, USA.
American journal of surgery
|March 30, 2025
概括
床边气管切除术 (BT) 比手术室气管切除术 (ORT) 对重症患者来说更具成本效益. 这一分析支持考虑为患有中低风险的术后肺炎的患者提供BT.
科学领域:
- 关键护理医学 关键护理医学
- 卫生经济学 卫生经济学
- 手术手术手术手术手术手术手术手术手术手术
背景情况:
- 之前的研究比较了床边气管切除术 (BT) 和手术室气管切除术 (ORT) 的结果和成本.
- 缺乏比较BT和ORT的正式成本效益分析.
研究的目的:
- 进行BT与ORT的成本效益分析.
- 评估不同气管切除手术的经济价值.
主要方法:
- 用于成本效益分析的马尔科夫微型模拟模型.
- 从现有文献中抽象的模型参数.
- 进行了决定性和概率性灵敏度分析.
主要成果:
- 在100,000美元/质量调整后的生命年支付意愿门,BT表现出比ORT更高的成本效益.
- 模型的灵敏度确定了术后肺炎的发病率和治疗成本作为关键因素.
- 在一系列支付准备门 ($0-$200,000) 中,BT的成本效益仍然更高.
结论:
- 床边气管切除术 (BT) 比手术室气管切除术 (ORT) 更具成本效益,用于患有低至平均术后肺炎风险的重症患者.
- 调查结果表明,不论是穿皮或开放的方法,都应该优先考虑BT而不是ORT.
- 这支持了对气管切除术放置的程序考虑的转变.
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